Madeline Claude

Individual provider Active NPI Clinical Social Worker · Centerville, UT

NPI 1053967752 · NPPES record last updated Sep 27, 2022

Key facts

NPI
1053967752
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
11792012-3501 (UT)
Practice address
520 N Market Place Dr
Centerville, UT 84014-4901
Phone
(801) 934-3373
NPI assigned
Aug 18, 2019
Sex
Female
Sole proprietor
No

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare Care Compare profile

Specialty
Clinical Social Worker
Education
University of Utah School of Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
South Davis Psychological Services (17 clinicians)

Practice addresses (Care Compare)

520 N Market Place Dr
Suite 200
Centerville, UT 84014-4904
Phone (801) 934-3373

Medicare participation

Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20221006000499 UT Practitioner - Clinical Social Worker 4082090527 Reassigns benefits to 1 organization

National Provider Directory

Medicare enrollment (NPD)
Yes

Practice roles

OrganizationSpecialtyStatusNew patients
Neurorev PLLC Current
since Sep 1, 2022
Accepting new patients
South Davis Psychological Services Current
since Sep 1, 2022
Accepting new patients

Locations

520 N Market Place Dr
Ste 200
Centerville, UT 84014
Phone (801) 243-6822

520 N Market Place Dr
Centerville, UT 84014
Phone (801) 934-3373

1544 Woodland Park Dr
Ste 320
Layton, UT 84041
Phone (801) 556-4751

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 11792012-3501 UT Yes
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

520 N Market Place Dr
Centerville, UT 84014-4901

Mailing address

520 N Market Place Dr
Centerville, UT 84014-4901
Phone (801) 934-3373

Other practice location 1

750 N Freedom Blvd
Provo, UT 84601-1677
Phone (801) 373-4760

Other providers in Centerville, UT

All providers in Centerville, UT · Clinical Social Worker in Utah

Sources for this page

Verify at the official NPI Registry.